Clinical observation of itopride and esomeprazole combining with deanxit in treating functional dyspepsia / 中国基层医药

Objective To investigate the clinical effect of Itopride and esomeprazole combining with deanxit in treating functional dyspepsia ( FD) .Methods Sixty-two patients meeting Rome Ⅲcriterion were randomly divided into the therapy groups which were treated with Itopride and esomeprazole combining with deanxit and the control groups which were treated with Itopride and esomeprazole for 4 weeks respectively .Symptom scoring was done before and after the treatment .Results The symptoms were remarkably improved , there was significant difference in the therapeutic effect between the two groups (P<0.05).The total efficiency was more obvious in the therapy group . Conclusion Itopride and esomeprazole combining with deanxit can produce an effect on the treatment of FD .Itopride and esomeprazole combining with deanxit has better clinical effect than Itopride and esomeprazole on the treatment of FD.

Sequential therapy versus standard triple therapy for duodenal ulcer with Hp infection / 中国综合临床

Objective To compare the efficacy of 10-day sequential therapy (including rabeprazole amoxillin clarithromycin tinidazole) and 7-day traditional trigeminy therapy (including rabeprazole amoxillin and clarithromycin) in patients with duodenobulbar ulcer and Hp infection. Methods Ninty-five patients with duodenobulbar ulcer and Hp infection were enrolled into the study and divided into two groups randomly:sequential therapy group and traditional trigeminy therapy group. Patients in the first group received 10-day sequential medications:rabeprazole 10 mg plus amoxillin 1 g for the first 5 days,followed by rabeprazole 10 mg plus clarithromycin 500 mg and tinidazole 500 mg for another 5 days;while in the second group patients received the standard 7-day traditional triple medications:rabeprazole 10 mg plus clarithromycin 500 mg and tinidazole 400 mg. All drugs were given twice daily. All patients received rabeprazole 10 mg daily following the two types of therapys for another four weeks. Hp statuses were assessed by rapid urease test and 14C urea breath test at baseline and 4 weeks after completion of the treatment. Ulcer cicatrization was assessed by gastroscope. Results The eradication rate of Hp infection was significantly higher in sequential group than triple group (89.5%vs. 70. 2%, P ＜ 0. 05 ), but we found no statistically significant difference in the comparison of the ulcer cicatrization rate between sequential group and triple group ( 87.5% vs. 82. 9%, P ＞ 0. 05 ). Conclusion Sequential therapy had a better Hp eradication effect than standard triple therapy, but the eradication rate was very close between the two therapys.

Clinical value of electronic gastroscope in diagnosis of bile reflux gastritis / 中国基层医药

Objective To analyze the cause of bile refluxing into stomach leading to stomach mucous membrane pathological changes and complications.To evaluate the accuracy of electronic gastroscope combining with clinical manifestation in diagnosis of bile reflux gastritis.Methods The extent of the bile refluxing,bile staining on muco sa and other pathological changes were observed by electronic gastroscope.Part of the patients underwent mucosa biopsy.Results Of the ten thousand patients who underwent electronic gastroscope,there were 1433 cases who presentedbile refluxing.The average age is 46.8 years-old,male and female ratio is 0.75 :1.Mucous membrane presented various degrees of erosion,congestion and edema.Part of the cases combined with peptic ulcer,reflux esophagitis or a trophic gastritis.None of them combined with gastric cancer or esophageal cancer.Conclusion Electronic gastroscope can be main means for diagnosis of bile reflux gastritis.If combined with bilirubin in gastral cavity determination,PH value of gastric juice determination and mucosa biopsy,it can be more scientific.

Detection of arterial blood gas and its clinical signification in the early stage of patients with acute pancreatitis / 中国基层医药

Objective To study the significance of acute pancreatitis AP complications by acid-base distur-bance. Methods The arterial blood gas, serum electrolytes parameter and clinical data of 85 patients were analyzed.Results Acid-base disturbance of different types commonly existed in the early stage of AP patients. There are sig-nificant statistical differences in the indices of PaO2, PaCO2, SaO2 between group MAP and group SAP( P < 0.05 or P < 0.01 ). Conclusion Acid-base disturbance are very common in the AP patients and this-will make the condition worse,they should be treated promptly.

Safety of metformin in the treatment of elderly type 2 diabetes mellitus / 中华内科杂志

Objective To evaluate the safety of mefformin in the treatment of elderly type 2 diabetes mellitus(T2DM). Methods Two hundred and forty-three cases of elderly T2DM hospitalized from Jan.1996 to Dec. 2006 were reviewed; the changes of fasting blood glucose(FBG), postprandial blood glucose (PBG), glycosylated hemoglobin (HbA1c), liver and renal function and blood lactic acid were evaluate before and after treatment. Results The mean time of treatment with mefformin was (6.6±3.9) years (3 months-21 years)in these 243 cases. The levels of FBG, PBG and HbAlc significantly reduced after treatment with mefformin only in 43 cases (17.7%), mefformin combined with other oral hypoglycemic drugs in 124 cases (51.0%) and mefformin combined with insulin in 76 cases (31.3%). There was only 18.1% of the cases with normal range ( > 80 ml/min) of creatinine clearance rate (Ccr), and 25.8% of the cases with Ccr≤50 ml/min. The liver and renal function as well as the blood lactic acid had no significant change after treatment no matter in total cases or in different groups separated by Ccr.Conclusions Mefformin is safety in the treatment of elderly T2DM patients. Ageing is not the contraindication of mefformin. To the patients with high risk, we should monitoring the level of blood lactic acid.

Clinical value of endoscopic sclerotherapy for esophageal varices bleeding / 中国基层医药

Objective To evaluate the clinical therapy effect of sclerosing agent and its safety on treatment of the patients with hemorrhage from esophageal varices.Methods The total of 114 patients with hemorrhage from varices were treated by three methods randomly.Among them,the number of groups of sclerosing agent,emergency treatment and prevential treatment were seventy-eight,forty-six and thirty-two respectively.Results There were forty-four emergency cases treateml by hemostasis.The positive bleeding rate of the patients with hemorrhage from esophageal vaxices after treatment and follow-up survey from one year to five years was 7.7%.The disappearance rate of varicose vein was 83%.Conclusion With the help of endoscope,the method of sclerosing agent on treatment of the patients with hemorrhage from esophageal varices was simple,safe and reliable.

CLINICAL ANALYSIS ON 16 CASES OF 21-HYDROXYLASE DEFICIENCY / 解放军医学杂志

To analyze the clinical characteristics of 21 hydroxylase deficiency and to improve its diagnosis and treatment, medical records of 16 in patients with 21 hydroxylase deficiency were carefully and retrospectively reviewed. The results showed that of the 16 cases, 1 was male with increased penile size, but no testicular enlargement. 15 were females with masculinized external genitalia to varying degrees even chordee in some cases, pigmentation (66 7%), hirsutism (60%), and ovarian dysfunction(40%). Laboratory tests showed elevated levels of serum ACTH, 24 hour urinary 17 KS, 17 KGS, and the results of medium dose dexamethasone suppression test were all positive. Fifteen cases received glucocorticoid replacement therapy and 12 female cases received corrective surgery. It is suggested that 21 hydroxylase deficiency, at present, still remains to be an underdiagnosed and undertreated disorder, therefore, more attention should be paid to it for improving the accuracy of diagnosis and adequacy of treatment.

Epidemiological Survey on Congenital De-formities of Bornbabies In Pollution Area of Taiyuan Suburbs / 环境与健康杂志

In order to the further prove the rela tions between the environmental pollution and the congenital deformities. We selected two villages in the Taiyuan Suburbs for our investigations. Wu village used the industrial sewages for irrigations and Ho village used the rainfall. All of the babies born during 1985.1.1-1988.12.31 were investigation. In Wu village the frequency of deformities was 67.42%. and in Ho village the frequency of deformities was 20.07%. The X2 significance test was 30.56 and P

CLINICAL SIGNIFICANCE OF PLASMA ACTH AND SERUM CORTISOL RADIOINMUNOASSAYS / 中华内分泌代谢杂志

The clinical significance of plasma ACTH and serum cortisol radioimmunoassays was evaluated. It was found that Addison's disease was characterised by high plasma ACTH and low serum cortisol. Adrenal tumors could be distinguished from Cushing's disease by low plasma ACTH level. The levels of both ACTH and cortisol were elevated in most patients with Cushing's diserse, and yet lowered in hypopituitarism; they had some overlap with normal values in either case. The low-dose dexamethasone suppression test was helpful to differential diagnosis between Cushing's disease and simple obesity. The aminoglutethimide test could be used to distinguish hypopituitarism from normal.In addition, the levels of ACTH and cortisol were measured in patients with obesity, hyperthyroidism and diabetes mellitus.

THE CHANGES IN PLASMA ACTH, SERUM CORTISOL AND UFC IN PATIENTS WITH ADRENAL INSUFFICIENCY / 解放军医学杂志

To evaluate the significance of plasma ACTH, serum cortisol and UFC levels as well as ACTH stimulation test, aminoglutethimide test and insulin induced hypoglycemia test in patients with adrenal insufficiency. Sixteen patients with primary insufficiency (Addison`s disease) and 75 cases with secondary insufficiency (hypopituitarism) diagnosed from 1985 to 1999 were reviewed. It was found that high levels of ACTH were detected in all patients with primary insufficiency, and in most of them the levels of cortisol and UFC were low. No response of cortisol and UFC were observed after ACTH stimulation in the patients with primary insufficiency, but normal or delayed action was observed in the patients with secondary adrenal insufficiency. In most of secondary adrenal insufficiency the ACTH levels were in normal range but the cortisol and UFC levels were low; the elevated action of ACTH by insulin induced hypoglycemia test or aminoglutethimide test did not appear in the patients with secondary adrenal insufficiency. The results suggested that the low levels of cortisol and UFC were a common feature in the most of patients both with primary or secondary adrenal insufficiency. The ACTH level was the key indicator to distinguish the primary adrenal insufficiency from secondary adrenal insufficiency, as the ACTH levels were remarkably elevated in primary patients but were normal or decreased in secondary insufficiency patients. The ACTH stimulation test was useful in the diagnosis of the primary or secondary adrenal insufficiency. The insulin induced hypoglycemia test or aminoglutethimide test was valuable in the diagnosis of the secondary adrenal insufficiency.

THE CHARACTERISTICS OF PLASMA ACTH, SERUM CORTISOL AND UFC IN 136 PATIENTS WITH CUSHING SYNDROME / 解放军医学杂志

To evaluate the significance of plasma ACTH (pACTH), serum cortisol (SC) and urinary free cortisol UFC as well as low or high dose dexamethasone suppression test in Cushing syndrome, the levels of hormones were evaluated in 136 cases of Cushing syndrome. It was found that the levels of SC and UFC were elevated in almost all the 121 patients with Cushing syndrome. The mean levels of pACTH were higher in 86 patients with Cushing disease and lower in 36 cases with adrenocortical tumor or ACTH independent nodular adrenocortical hyperplasia (AINAH) than those in normal subjects. The ACTH levels might be in normal range in many patients with Cushing syndrome, but they were higher in patients with Cushing disease and lower in the patients with adrenocortical tumor or AINAH than those of the high limit at ACTH0am in normal subjects. It was a common feature that the diurnal rhythm of hormone secretion disappeared and the hormone levels were not suppressed by low dose dexamethasone suppression test in the patients with Cushing syndrome. In more than 90% of the patients with adrenocortical tumor or AINAH the levels of SC and UFC were not suppressed by high dose dexamethasone. In 12 of clinically cured patients with Cushing disease the levels of pACTH8am, SC8am and UFC were normal or even low. The pACTH levels were low in two patients with iatrogenic Cushing syndrome. The results suggested that examinations of SC, UFC and low dose dexamethasone suppression test were very important in the diagnosis of Cushing syndrome. The pACTH level was a key parameter to distinguish Cushing disease from adrenocortical tumor or AINAH.